| NPI | 1023206794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D74757) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 49914) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TX N6806) | |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2023-09-25 |